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The Department of Justice (DOJ) recently accused a Texas pharmacist of partaking in a scheme to defraud the government. The agency claimed the medical professional and his wife billed the federal government for over $20 million for medically unnecessary topical...
The government uses the Anti-Kickback Statute (AKS) to help better ensure doctors are not letting financial gain impact decisions about patient care. As a result, the government may make an AKS claim if a doctor is getting payment or has some financial benefit from an...
Patients are not the only ones who pay the bill when it comes to medical care. In some cases, the government is also spending money. The government may pay the entire or a portion of the bill, for example, for Medicare patients. As a result, lawmakers have put various...
The Centers for Medicare and Medicaid Services (CMS) recently released a proposal to change the Stark Law. The proposal is not current law, but the agency has stopped taking public comments. #1: Volume to value. The federal agency claims that it supports a shift from...
Lawmakers are encouraging the United States Department of Health and Human Services (HHS) to increase oversight of patient assistance charities. These charities are set up to help pay for the cost of prescription medications. However, there are allegations the...
On October 9, 2019, the United States Department of Health and Human Services (HHS) proposed some of the largest changes to the Stark Law, which guides physician self-referrals, and the Anti-Kickback Statute (AKS) discussed in decades. The proposals are part of the...
The government has continued its prosecution of those connected to a health care fraud case that extended past borders in what the Justice Department has called “one of the largest health care fraud schemes prosecuted to date in the U.S.” The most recent agreement...
The government recently accused a Texas woman of partaking in a health care fraud scheme that took place in Arkansas. The woman allegedly used her role recruiting patients for a company that marketed prescription medications for a Mississippi pharmacy.The prosecution...
The Department of Justice (DOJ) recently charged 30 in a "patients for cash" health care fraud scheme. According to the indictment, a home health organization illegally paid doctors, nurses, and at least one social worker along with other medical professionals in...
Novartis Pharmaceuticals Corp. (Novartis) recently announced it will set aside $700 million to settle claims made by the Department of Justice (DOJ). The DOJ recently accused the pharmaceutical giant of illegally bribing physicians and other health care professionals...